| NPI | 1053957613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCIS MCCUSKER Office Manager 215-454-6016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2023-04-22 |